The effectiveness of working wrist splints in adults with rheumatoid arthritis: A mixed methods systematic review
Lucia Ramsey, Robert John Winder , Joseph G. McVeigh
Centre for Health and Rehabilitation Technologies (CHaRT), School of Health Sciences, University of Ulster, Shore Road, BT370QB UK, United Kingdom. E-mail: firstname.lastname@example.org
Objective: To evaluate the effectiveness of working wrist splints in people with rheumatoid arthritis.
Data sources and study selection: This review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Ten databases were searched from inception until September 2012 for quantitative and qualitative studies on the effectiveness of working wrist splints in rheumatoid arthritis.
Data extraction: Data was extracted on participants, interventions, outcome measures and results. Experimental studies were evaluated using the van Tulder scale and the Cochrane Risk of Bias tool. Data was extracted by a single reviewer and all studies were reviewed by two blind reviewers.
Data synthesis: Twenty-three studies were included in the review (n = 1,492), 13 experimental studies including 9 randomized controlled trials (RCTs) and 2 qualitative studies. Data was summarized using best evidence synthesis and a meta-ethnographical approach guided qualitative evidence synthesis. There is strong quantitative evidence (including 9 RCTs), supported by conclusions from qualitative literature, that working wrist splints reduce pain (d = 0.7–0.8), moderate evidence that grip strength is improved (d = 0.3–0.4) and dexterity impaired and insufficient evidence of their effect on function.
Conclusions: Working wrist splints reduce pain and improve grip in rheumatoid arthritis. The effect of splints on function is not yet clear.
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